scholarly journals A comparative study to assess the effect of escitalopram and amitriptyline on psychomotor functions in patients of depression

2020 ◽  
Vol 9 (11) ◽  
pp. 1701
Author(s):  
Amit V. Mohite ◽  
Baliram V. Ghodke ◽  
Patil Arun W.
Keyword(s):  
Reaction Time ◽  
Reuptake Inhibitor ◽  
Serotonin Reuptake ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Tricyclic Antidepressant ◽  
Significant Rise ◽  
Selective Serotonin ◽  
Psychomotor Function ◽  
Flicker Fusion Frequency ◽  
Visual Reaction

Background: Depression is a most common and widespread of all psychiatric disorders. Treatment of depression includes the use of antidepressants commonly used clinically such as tricyclic antidepressants, selective serotonin reuptake inhibitors, selective norepinephrine reuptake inhibitor, and monoamine oxidase inhibitors. Certain antidepressants apart from improvement in the symptoms found to have detrimental effect on cognitive and psychomotor function. Objective of this study was to assess and to compare the effect of escitalopram and amitriptyline on cognitive and psychomotor functionsMethods: Effect of escitalopram and amitriptyline on psychomotor function was assessed by using Critical flicker fusion frequency (CFF) and Reaction time (RT) in patients of mild to moderate depression at the end of 2nd and 4th week of monotherapy.Results: Patients in both the group have their RT remained significantly higher (p<0.001) in comparison with control and CFF remained significantly lower at the end of both the week. There was a significant rise in CFF in escitalopram group as compared to amitriptyline (p<0.001). Escitalopram showed a significant improvement in Visual reaction time (VRT), Auditory reaction time (ART) and Choice reaction time (CRT) (p<0.001) compared to amitriptyline at both the follow ups.Conclusions: Findings of this study support the use of Selective serotonin reuptake inhibitor (SSRI) i.e. escitalopram which had shown less impairment of psychomotor function in patients of Depression as compared to amitriptyline (Tricyclic antidepressant), in special subgroups of population who operate machinery, drive vehicle or require alertness for the work.

scholarly journals Strategies for Managing Depression Refractory to Selective Serotonin Reuptake Inhibitor Treatment: A Survey of Clinicians

2000 ◽  
Vol 45 (5) ◽  
pp. 476-481 ◽  
Author(s):  
David Mischoulon ◽  
Andrew A Nierenberg ◽  
Leena Kizilbash ◽  
Jerrold F Rosenbaum ◽  
Maurizio Fava
Keyword(s):  
Reuptake Inhibitor ◽  
Serotonin Reuptake ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Monoamine Oxidase Inhibitor ◽  
Oxidase Inhibitor ◽  
Tricyclic Antidepressant ◽  
Selective Serotonin ◽  
Treatment Practices ◽  
Group Settings ◽  
First Choice

Objective: To examine treatment practices in cases where selective serotonin reuptake inhibitors (SSRIs) are ineffective. Methods: We surveyed 801 clinicians (including 630 psychiatrists) attending the Massachusetts General Hospital's annual psychopharmacology review course. Clinicians were presented with a vignette about a patient with depression who had responded partially to an SSRI and were asked to choose among various strategies available to manage this patient. Results: Of those surveyed, 466 clinicians had been in practice a mean of 16.6 years (SD 10.7). Not all clinicians chose to answer every question. Among 455 respondents, 84% (n = 382) chose to increase the dose of the SSRI, 10% (n = 47) chose augmentation or combination, and 7%(n = 31) opted for switching agents. When asked to switch to another agent, 448 responded, of whom 52% (n = 235) chose a newer antidepressant, 34% (n = 152) chose another SSRI, 10%(n = 44) chose a tricyclic antidepressant (TCA), 2%(n = 8) chose a serotonin norepinephrine reuptake inhibitor (SNRI), 1% (n = 5) chose a monoamine oxidase inhibitor (MAOI), and 1% (n = 4) chose an undefined “other” agent. Among 445 respondents, bupropion was the most widely chosen augmenting agent (30%, n = 134), followed by lithium (22%, n = 98). West coast and Canadian clinicians preferred to switch to another SSRI rather than to a newer antidepressant. Canadian clinicians preferred lithium to bupropion as their first-choice augmenting agent, as did clinicians from academic settings. Clinicians from community, individual practice, or group settings favoured bupropion. More experienced clinicians preferred bupropion as a first-choice augmenter, whereas less experienced ones showed a slight preference for lithium. Canadian clinicians were more likely to use MAOIs as second-line agents. Conclusions: Clinicians in this sample often followed strategies different from those recommended in the literature. Bupropion may have an important role in augmentating treatment with SSRIs.

scholarly journals Trends and Advances in Separation and Detection of SSRIs and SNRIs in Biological Matrices

2013 ◽  
Vol 2013 ◽  
pp. 1-15 ◽  
Author(s):  
Ruchita Das ◽  
Y. K. Agrawal
Keyword(s):  
Reuptake Inhibitor ◽  
Serotonin Reuptake ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Date Rape ◽  
Antidepressant Drugs ◽  
Selective Serotonin ◽  
Biological Matrices ◽  
First Choice ◽  
Analytical Approaches ◽  
Norepinephrine Reuptake

Nowadays antidepressant drugs like selective serotonin reuptake inhibitors (SSRIs) and selective norepinephrine reuptake inhibitors (SNRIs) represent the first choice in the treatment of moderate to severe depressive illness, various phobias, and personality disorders. In spite of the therapeutic aspects, they often produce very severe and toxic effects in deliberate and accidental cases of poisoning. These are also considered as date-rape drugs used for drugged victims for raping or robbing. Therefore, in recent years, their analyses in different biological matrices for clinical and toxicological analysis purposes has been a target worthy of interest. Thus, the review focuses on recent advancements of various separation techniques like chromatography and electrophoresis that are concernd with the determination of selective serotonin reuptake inhibitor and selective norepinephrine reuptake inhibitor drugs and their metabolites in various biological matrices. In addition to this, a critical discussion on analytical approaches has also been incorporated, suggesting their applicability and limitations for further implementations. Thus, this paper will definitely help in the selection and development of proper analytical methodologies to achieve satisfactory results, better scientific understanding, and test interpretation.

scholarly journals Paroxetine and bupropion have no in vitro effects on lynphocyte proliferation and viability

2007 ◽  
Vol 56 (2) ◽  
pp. 116-119 ◽  
Author(s):  
Ramiro Ronchetti ◽  
Mariana Dal Pizzol ◽  
Rodrigo Pestana Lopes ◽  
Rachel Rubin da Silva ◽  
Gabriel José Chittó Gauer ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Cell Viability ◽  
Reuptake Inhibitor ◽  
Peripheral Blood ◽  
Serotonin Reuptake ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Selective Serotonin ◽  
Favorable Effect ◽  
Immunological Effects

OBJECTIVE: Initial studies with tricyclic antidepressants demonstrated that they jeopardize the immune system activity. Recent studies suggested that selective serotonin reuptake inhibitors would have stimulating immunological effects. Here, we explored the in vitro immunological effects of two antidepressants used in clinical practice, paroxetine (selective serotonin reuptake inhibitor) and bupropion (norepinephrine and dopamine reuptake inhibitor). METHOD: Peripheral blood samples were obtained from 16 healthy volunteers and the peripheral blood mononuclear cells were isolated and cultured in vitro. We evaluated the effects of bupropion and paroxetine on cell viability as well as the ability to suppress phytohemagglutinin-induced lymphocyte proliferation. RESULTS: Both antidepressants produced neither significant effect on cell viability nor on T-cell proliferation. CONCLUSIONS: This could be of valuable information for the clinical practice when these drugs are administered. These results indicate a more favorable effect of such psychopharmacological drugs when compared to reported immunological effects associated with tryciclic antidepressants.

scholarly journals Sex differences in depressive symptoms and tolerability after treatment with selective serotonin reuptake inhibitor antidepressants: Secondary analyses of the GENPOD trial

2021 ◽  
pp. 026988112098641
Author(s):  
Marilia Gougoulaki ◽  
Glyn Lewis ◽  
David J Nutt ◽  
Tim J Peters ◽  
Nicola J Wiles ◽  
...  
Keyword(s):  
Sex Differences ◽  
Depressive Symptoms ◽  
Reuptake Inhibitor ◽  
Serotonin Reuptake ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Menopausal Status ◽  
Physical Symptoms ◽  
Treatment Discontinuation ◽  
Selective Serotonin ◽  
Secondary Analyses

Background: Differences in serotonergic neurotransmission could lead to sex differences in depressive symptoms and tolerability after treatment with selective serotonin reuptake inhibitors (SSRIs). Aims: We investigated whether women have greater reductions in depressive symptoms than men after treatment with an SSRI (citalopram) compared with a noradrenaline reuptake inhibitor (reboxetine) control, and after antidepressant treatment irrespective of class. We also investigated tolerability and the influence of menopausal status. Methods: Secondary analyses of the GENPOD (GENetic and clinical Predictors Of treatment response in Depression) trial. Six hundred and one people with depression were recruited from UK primary care and randomized to citalopram or reboxetine. Beck Depression Inventory (BDI-II) score at 6 weeks was the primary outcome. Secondary outcomes included BDI-II score at 12 weeks, and physical symptoms and treatment discontinuation. We calculated main effects and interaction terms using linear and logistic regression models. Results: There was no evidence that women experienced greater reductions in depressive symptoms than men when treated with citalopram compared with reboxetine. We also found no evidence of sex differences at six or 12 weeks (irrespective of antidepressant class): men scored −0.31 (95% confidence interval (CI) −2.23 to 1.62) BDI-II points lower than women at six weeks and −0.44 (95% CI −2.62 to 1.74) points lower at 12 weeks. There was no evidence of sex differences in physical symptoms or treatment discontinuation and no evidence for an influence of menopausal status. Conclusion: Citalopram was not more effective in women compared with men and there was no difference in tolerability. Women and men had similar prognosis after SSRI treatment and similar prognosis regardless of antidepressant class. Findings were unaltered by menopausal status.

scholarly journals FRI0133 RELATIONSHIP BETWEEN MELATONIN SERUM LEVELS AND THE EFFICACY OF SELECTIVE SEROTONIN REUPTAKE INHIBITOR PAROXETINE IN PATIENTS WITH RHEUMATOID ARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 649.2-649
Author(s):  
Y. Sikalo ◽  
L. Zhuravlyova ◽  
M. Oliinyk
Keyword(s):  
Rheumatoid Arthritis ◽  
Healthy Volunteers ◽  
Selective Serotonin Reuptake Inhibitor ◽  
Reuptake Inhibitor ◽  
Serotonin Reuptake ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Selective Serotonin ◽  
Melatonin Level ◽  
Serotonin Reuptake Inhibitor ◽  
Basic Treatment

Background:Numerous clinical and epidemiological studies have established that there is a close relationship between inflammation, chronic pain and psycho-emotional disorders in rheumatoid arthritis [1, 2]. The common pathogenetic mechanism is manifested in the defect of melatonin mediation and cytokine stimulation [3]. Therefore, features of the use of selective serotonin reuptake inhibitors is relevant.Objectives:To study the relationship between serum melatonin level and the efficacy of selective serotonin reuptake inhibitor paroxetine in patients with RA.Methods:A total of 127 RA patients and 71 healthy volunteers were examined. The following information was collected for each patient: medical history data, physical examination results, serum melatonin levels. RA patients were randomly categorized into two treatment groups – 63 and 64 patients. The basic treatment for patients of both groups included nonsteroidal anti-inflammatory drugs, glucocorticoids (equivalent to 10 mg of prednisolone), and disease-modifying antirheumatic drugs (methotrexate, leflunomide or sulfasalazine). To evaluate the effectiveness of treatment, patients of both groups were further divided into three subgroups depending on the serum melatonin level (low level corresponds to 25 percentile, medium - 25-75, high - 75 percentile). First group received paroxetine 20 mg once a day for 12 weeks in addition to the basic treatment. Effectiveness of the treatment was evaluated according to the ACR/EULAR criteria.Results:The mean baseline plasma melatonin levels in RA patients were significantly higher than in the healthy volunteers (26.1±32.7 vs 13.6±4.6 pg/mL at 8 am and 11.5±15.5 vs 3.6±4.6 pg/mL at 20 pm (р<0,001), respectively). A good response to basic treatment was observed in groups with medium and high serum melatonin levels, who received paroxetine (p<0.05). However, patients who did not receive paroxetine gave best response to treatment in group with low serum melatonin levels (p<0.05).Conclusion:Obtained data suggest that the high level of serum melatonin is one of the predictors of resistance for basic RA treatment. The proposed scheme of treatment with addition of paroxetine demonstrated high efficacy concerning the main manifestations of the disease in RA patients with high melatonin serum level. This study demonstrates the possible influence of serotoninergic interactions on the melatoninergic system and their contribution to the pathogenesis of RA.References:[1]Odegård S, Finset A, Mowinckel P, Kvien TK, Uhlig T. Pain and psychological health status over a 10-year period in patients with recent onset rheumatoid arthritis. Ann Rheum Dis. 2007 Sep;66(9):1195-201. doi: 10.1136/ard.2006.064287. Epub 2007 Mar 28. PMID: 17392351; PMCID: PMC1955161.[2]Sturgeon JA, Finan PH, Zautra AJ. Affective disturbance in rheumatoid arthritis: psychological and disease-related pathways. Nat Rev Rheumatol. 2016 Sep;12(9):532-42. doi: 10.1038/nrrheum.2016.112. Epub 2016 Jul 14. PMID: 27411910; PMCID: PMC5449457.[3]Lin GJ, Huang SH, Chen SJ, Wang CH, Chang DM, Sytwu HK. Modulation by melatonin of the pathogenesis of inflammatory autoimmune diseases. Int J Mol Sci. 2013 May 31;14(6):11742-66. doi: 10.3390/ijms140611742. PMID: 23727938; PMCID: PMC3709754.Disclosure of Interests:None declared

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